Mucin 5AC is significantly upregulated in exosomes from the nasal lavage fluid and may promote the expression of COX-2, VEGF and MMP-9: an implication in nasal polyp pathogenesis.

BACKGROUND: Exosomes are critical mediators of intercellular communication and could be involved in many human diseases; however, little is known about the role of exosomes in nasal polyps (NP). METHODS: Exosomes in nasal lavage fluids (NLF) were isolated by ultracentrifugation. Exosome identity was validated by nanoparticle tracking analysis (NTA), transmission electron microscopy (TEM) and specific exosomal markers. The exosome proteome was revealed by LC-MS/MS, and the expression of the candidate exosomal protein, mucin 5AC, was confirmed by Western blot analysis and immunohistochemistry (IHC). Cellular uptake of the exosomes was monitored by fluorescence confocal microscopy and the ensuing effects on COX-2, VEGF and MMP-2/MMP-9 were determined by Western blotting, ELISA and gelatin zymography, respectively. RESULTS: Mass spectrometry analysis and subsequent verification by Western blotting identified that mucin 5AC was significantly upregulated in exosomes from NLFs of NP patients. Moreover, the expression of mucin 5AC was increased in the tissue specimens of the NP patients. Functional assays suggest that the mucin 5 AC-enriched exosomes could be effectively taken up by chronic rhinosinusitis without NP (CRSsNP)-derived fibroblasts, the control cells, resulting in a significant increase in the expression of COX-2, VEGF and MMP-9. CONCLUSIONS: Mucin 5AC, the major airway mucin, cannot only be carried and transferred by nasal exosomes, but may also promote tissue remodeling and angiogenesis and thus could be a potential therapeutic target of NP.

Predictive factors for post-operative drainage after partial superficial parotidectomy: a case-control study.

OBJECTIVES: This study aimed to identify the pattern of post-operative drainage following partial superficial parotidectomy with and without the use of a bipolar vessel-sealing device. METHODS: Of the 49 patients undergoing parotidectomies, a bipolar vessel-sealing device was used for 20. Predictive factors included in the analysis were age, sex, body weight, operating time, tumour pathology, and diabetes mellitus, hypertension and smoking status. RESULTS: In multivariate analyses, body weight (p = 0.026) and non-use of a bipolar vessel-sealing device (p = 0.009) were significantly associated with increased post-operative drainage after 24 hours. There was also a trend towards increased drainage in diabetic patients. Operating times were significantly shorter in the bipolar vessel-sealing device group. CONCLUSION: Although 24-hour drainage appears adequate for most patients, in obese and diabetic individuals there is a risk of requiring increased drainage. Therefore, the drain should be left in place for a longer period. The bipolar vessel-sealing device is safe and time-efficient, and decreases the post-operative drainage period.

Size tunable Ge quantum dots for near-ultraviolet to near-infrared photosensing with high figures of merit.

We report a unique approach for the inclusion of size-tunable (7-50 nm), spherical Ge quantum dots (QDs) into gate stacks of metal-oxide-semiconductor (MOS) diodes, through selective oxidation of SiGe layers over the buffer layer of Si3N4 deposited over the Si substrate. In this complementary MOS (CMOS)-compatible approach, we successfully realized high performance nm scale Ge-QD MOS photodetectors with high figures of merit of low dark current density (1.5 × 10(-3) mA cm(-2)), superior photo-current-to-dark current ratio (13 500), high photoresponsivity (2.2 A W(-1)), and fast response time (5 ns), which are ready for direct integration with Si CMOS electronic circuits. Most importantly, the detection wavelength of the Ge QDs is tunable from near infrared to near ultraviolet by reducing the QD size from 50 to 7 nm as well as the optimal photoresponsivity is tailored by the Ge QD size and the effective thickness of gate dielectrics.

Lactate dehydrogenase isoenzyme patterns in auricular pseudocyst fluid.

OBJECTIVE: We investigated lactate dehydrogenase isoenzyme patterns in the cyst fluid of auricular pseudocysts and autogenous blood, to assist the diagnosis of auricular pseudocyst. METHODS: Twenty patients with auricular pseudocysts participated in this study conducted in Kaohsiung Medical University Hospital between February 2007 and June 2010. Patterns of lactate dehydrogenase in cyst fluid and autogenous blood were analysed. RESULTS: Levels of lactate dehydrogenase 1 and 2 were lower in auricular pseudocysts than in autogenous blood, whereas levels of lactate dehydrogenase 4 and 5 were higher; this difference was statistically significant (p < 0.001). CONCLUSION: Lactate dehydrogenase isoenzyme patterns in auricular pseudocyst fluid indicated higher percentage distributions of lactate dehydrogenase 4 and 5 and lower percentage distributions of lactate dehydrogenase 1 and 2. An effective laboratory method of evaluating the different lactate dehydrogenase isoenzyme components was developed; this method may improve the accuracy of auricular pseudocyst diagnosis.

Formation of Ge quantum dots array in layer-cake technique for advanced photovoltaics.

We report a simple and manageable growth method for placing dense three-dimensional Ge quantum dot (QD) arrays in a uniform or a graded size distribution, based on thermally oxidizing stacked poly-SiGe in a layer-cake technique. The QD size and spatial density in each stack can be modulated by conditions of the Ge content in poly-Si(1-x)Ge(x), oxidation, and the underlay buffer layer. Size-dependent internal structure, strain, and photoluminescence properties of Ge QDs are systematically investigated. Optimization of the processing conditions could be carried out for producing dense Ge QD arrays to maximize photovoltaic efficiency.

Expression of FLJ10540 is correlated with aggressiveness of oral cavity squamous cell carcinoma by stimulating cell migration and invasion through increased FOXM1 and MMP-2 activity.

Matrix metalloproteinase (MMP)-2 plays critical roles in tumor development and in the metastasis of multiple cancers, including human oral cavity squamous cell carcinoma (OCSCC). One of the upstream regulators of MMP-2 is FOXM1, which is overexpressed in a microarray dataset of OCSCC. It is interesting that FLJ10540 exhibits similar gene expression profiles with MMP-2 and FOXM1, raising the possibility that these molecules might participate in MMP-2-elicited cancer progression and metastasis of OCSCC. To examine this connection, we first showed that FLJ10540 was significantly overexpressed in OCSCC. A strong FLJ10540 expression was significantly correlated with an advanced tumor node metastasis stage and the cumulative 5-year survival rate. Thus, an elevated FLJ10540 expression is an indicator of poor survival. Functionally, FLJ10540 had the abilities to stimulate cell migration and invasion in oral cancer cells through increased FOXM1 and MMP-2 expressions. Conversely, the depletion of the FLJ10540 expression by small interfering RNAs suppressed the FOXM1 and MMP-2 protein expressions. The suppression of either FLJ10540 or FOXM1 could cause significant inhibition on cell migratory and invasive ability in oral cancer cells. Finally, the immunohistochemical and western blotting analyses of human aggressive OCSCC specimens showed a significant positive correlation among FLJ10540, FOXM1 and MMP-2 expressions. These findings suggest that FLJ10540 is not only an important prognostic factor but also a new therapeutic target in the FLJ10540/FOXM1/MMP-2 pathway for OCSCC treatment.

Ischaemic infarction masking aortic dissection: a pitfall to be avoided before thrombolysis.

Acute aortic dissection complicated by stroke is not uncommon but may be difficult to evaluate, especially in patients with impaired mental status. This report describes a patient who had evidence of an ischaemic stroke but was fortuitously not given thrombolytic treatment. She was subsequently found to have an extensive aortic dissection involving both carotid arteries. The decision of whether to give thrombolytic treatment is understandably an urgent one, but careful attention should be paid to subtle signs and symptoms such as atypical chest pain and carotid bruits that might suggest aortic dissection, especially involving the carotid arteries. There should be a high index of suspicion for acute aortic dissection in such cases and a low threshold for performing carotid ultrasound.

Overexpression of beta2-microglobulin is associated with poor survival in patients with oral cavity squamous cell carcinoma and contributes to oral cancer cell migration and invasion.

beta2-Microglobulin (beta2M), a component of MHC class I molecules, is believed to be associated with tumour status in various cancers. In this study, we examined the expression of beta2M at different malignant stages of oral cavity squamous cell carcinoma (OCSCC). To determine the possible correlation between beta2M expression and various clinical characteristics, 256 samples from patients with OCSCC were evaluated by immunohistochemical staining. Strong beta2M expression was significantly correlated with a relatively advanced tumour stage (P<0.001), positive nodal status (P<0.001), and TNM stage (P<0.001). The cumulative 5-year survival rate was significantly correlated with a relatively advanced tumour stage (P<0.001), positive nodal status (P<0.001), TNM stage (P<0.001), and strong expression of beta2M (P<0.001). Thus, elevated beta2M expression is an indicator of poor survival (P<0.001). In addition, we extended our analysis of beta2M expression to the FaDu and SCC25 oral cancer cell lines. beta2-Microglobulin expression was positively correlated with cell migration and invasion in beta2M-overexpressing transfectants in Transwell chambers. The suppression of beta2M expression using small interfering RNA (siRNA) was sufficient to decrease cell migration and invasion in vitro. Taken together, our results suggest that beta2M expression in the tissues is associated with survival and may be involved in tumour progression and metastasis in OCSCC.

Polymorphous low-grade adenocarcinoma of the nasopharynx: a case report and brief review.

Polymorphous low-grade adenocarcinoma (PLGA) is a rare tumour that mostly affects oral minor salivary glands. Our review of the literature found that there are only two reported cases of PLGA originating in the nasopharynx. Another nasopharyngeal PLGA in a 14-year-old boy is reported, focusing on the histopathological features and ultrastructural findings.

Expressed transcripts associated with high rates of egg production in chicken ovarian follicles.

The purpose of this study was to characterize differentially expressed transcripts associated with varying rates of egg production in Taiwan country chickens. Ovarian follicles were isolated from two strains of chicken which showed low (B) or high (L2) rates of egg production, then processed for RNA extraction and cDNA library construction. Three thousand and eight forty clones were randomly selected from the cDNA library and amplified by PCR, then used in microarray analysis. Differentially expressed transcripts (P<0.05, log(2)> or = 1.75) were sequenced, and aligned using GenBank. This analysis revealed 20 non-redundant sequences which corresponded to known transcripts. Eight transcripts were expressed at a higher level in ovarian tissue prepared from chicken strain B, and 12 transcripts were expressed at a higher level in L2 birds. These differential patterns of expression were confirmed by semi-quantitative RT-PCR. We show that transcripts of cyclin B2 (cycB2), ferritin heavy polypeptide 1 (FTH1), Gag-Pol polyprotein, thymosin beta4 (TB4) and elongation factor 1 alpha1 (EEF1A1) were enriched in B strain ovarian follicles. In contrast, thioredoxin (TXN), acetyl-CoA dehydrogenase long chain (ACADL), inhibitor of growth family member 4 (ING4) and annexin II (ANXA2) were expressed in at higher levels in the L2 strain. We suggest that our approach may lead to the isolation of effective molecular markers that can be used in selection programs in Taiwan country chickens.

Ablation of advanced tongue or base of tongue cancer and reconstruction with free flap: functional outcomes.

AIM: To evaluate the functional outcomes of patients who underwent total or nearly total glossectomy for advanced tongue or base of tongue cancer. MATERIAL AND METHODS: We used the radial forearm free flap (RFFF), anterior lateral thigh flap (ALTF) or fibular osteocutaneous flap (FOCF) to reconstruct the oral defect after radical resection in 39 patients undergoing total or nearly total glossectomy with laryngeal preservation. RESULTS: Good functional outcomes, measured by independent feeding, speech and swallowing were achieved in 35, 36 and 35 patients, respectively. The cumulative 4-year survival rates were 63.8% for tongue cancer and 42.9% for base of tongue cancer. CONCLUSION: Reconstruction with free flaps is a feasible method to restore the functional outcomes in speech and deglutition among patients who undergo total or nearly total glossectomy with laryngeal preservation.

Manufacturing artificial aggregates from industrial sludge and marine clay with addition of sodium salt.

The potential of converting industrial sludge and dredged marine clay into building and construction materials as an alternative to disposal was investigated in this study. The industrial sludge was mixed with marine clay at various compositions and was shaped into round pellets to be used as concrete aggregates. The pellets were then dried and transferred into a high temperature kiln where they were heated at 1,135 degrees C. The artificial aggregates were more porous then the normal granite aggregate. The occurrence of this condition was suspected to be attributed to two factors, viz. the firing temperature and the amount of sodium in the aggregates. To validate this hypothesis, the aggregates with and without added sodium chloride were fired at temperatures of 1,100 and 1, 200 degrees C. Results showed a reduction in the densities of the aggregates with the addition of sodium chloride and the increase in firing temperature.

Network strength and dewaterability of flocculated activated sludge.

Works in literature proposed the use of the rheological properties of wastewater sludges as an index for conditioner assessment and control. We demonstrated in this work, on the contrary, that one could not justify the consistency of the commonly used rheological characteristics of the sewage sludge samples taken from the same site but at different dates. A physically relevant index was proposed instead for describing the total network strength, which was hypothesized to correlate the dewatering efficiency of flocculated sludge. Based on this index, the network of a sludge was demonstrated to be largely destroyed after shearing, while the relaxation in an unbound environment or mild pouring over action could partially reinstall the structure. Moreover, a uniform shear rate field could produce network of greater strength when compared with that conditioned in a stirred tank.

Survival after early surgical revascularization in patients with both acute myocardial infarction and cardiogenic shock.

BACKGROUND AND PURPOSE: Previous studies have reported encouraging results with percutaneous transluminal coronary angioplasty (PTCA) in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock. However, PTCA is often unsuccessful and the mortality rate is more than 80%. The success rate of early surgical revascularization in patients with cardiogenic shock and failed PTCA is not clear. This study assessed the effect of early surgical revascularization on survival chances in patients with cardiogenic shock and failed PTCA. PATIENTS AND METHODS: Nineteen patients referred to our hospital by cardiologists due to cardiogenic shock and failed PTCA were included in this study. During the period from February 1995 through August 1997, seven patients were treated using mechanical circulatory support with extracorporeal membrane oxygenation (ECMO) and no surgical revascularization, and from August 1997 through June 1999, 12 patients underwent emergency surgical revascularization. The patient characteristics and in-hospital mortality were compared between groups. RESULTS: Ten patients were treated after acute infarction and nine were treated after cardiac intervention. No significant differences were found between the two groups in age, sex, hypertension, diabetes, smoking, and previous infarction. The in-hospital mortality rates were 100% in patients receiving mechanical circulatory support with ECMO and 25% in patients who underwent emergency surgical revascularization (p = 0.003). In the emergency revascularization group, four of 12 patients had surgical revascularization more than 18 hours after AMI and the in-hospital mortality rate was 25%. CONCLUSION: Surgical revascularization improved survival in patients with cardiogenic shock and failed PTCA.

Surgical revascularization for acute total occlusion of left main coronary artery.

We report our experience with emergency surgical revascularization in 3 patients who were in cardiogenic shock as a result of acute total occlusion of the left main coronary artery. Because they were in profound shock, 2 patients required mechanical support with extracorporeal membrane oxygenation before the operation. Another patient was given moderate inotropic support and treated with an intraaortic balloon pump before surgery, because he had a dominant right coronary artery with extensive collateral circulation to the left coronary artery. All 3 patients underwent surgical revascularization within 20 hours of acute occlusion. Two patients survived, although 1 of them required extracorporeal membrane oxygenation support for 5 days postoperatively. The 3rd patient, despite successful weaning from extracorporeal membrane oxygenation immediately after coronary revascularization, died of hypoxic encephalopathy due to prolonged preoperative resuscitation. Immediate surgical revascularization was an effective treatment in our 3 patients who were in cardiogenic shock due to acute total occlusion of the left main coronary artery. Such factors as abundant collateral vessels from the right coronary artery to the left coronary artery, complete surgical revascularization within 20 hours of acute occlusion, and mechanical circulatory support were deemed important to recovery of left ventricular function. Two of our 3 patients survived.

Thamnocephalis quadrupedata (Mucorales) as a mycoparasite of the entomophthoraceous fungus Basidiobolus ranarum.

A mycoparasite identified as Thamnocephalis quadrupedata (Mucorales) was observed on cultures of the frog dung fungus, Basidiobolus ranarum. The parasitic fungus, T. quadrupedata possessed infection hyphae with appressoria and penetrating hyphae to attack their host prey and adhere firmly to the surface. The invasion was often by slender infection hyphae or infecting pegs which grew from the appressoria and penetrated the chitin-protein cuticle by both mechanical pressure and exocellular enzymes. The host fungus, B. ranarum, possessing primary conidia, capilliconidia, hyphal bodies, vegetative mycelia and zygospores, were infected by means of direct penetration and intrahyphal growth, resulting in host cell death. T. quadrupedata may also grow as a saprophyte on damp filter paper in a Petri dish, manifesting facultative necrosis.

Aorto-right artrial fistula: a rare complication of aortic dissection.

We describe the successful surgical repair of an acute aortic dissection that had caused an aorto-right atrial fistula in a 67-year-old man. The patient was admitted to the hospital on an emergency basis because of severe heart failure. The diagnosis of acute aortic dissection with rupture into the right atrium was confirmed by use of intraoperative transesophageal echocardiography, although rupture of a sinus of Valsalva aneurysm into the right atrium had been suggested initially by 2-dimensional and Doppler transthoracic echocardiography. At surgery, we found the patient to have aortic arch dissection with complete separation of the right coronary artery from the sinus of Valsalva and a false lumen that had ruptured into the right atrium. The aortic arch was repaired directly. The ascending aorta was successfully replaced with a composite graft. Aortic dissection with rupture into the right atrium is extremely rare and leads to death rapidly. As shown in this case, such a condition might be mistaken for an aneurysmal rupture of the sinus of Valsalva, with use of transthoracic echocardiography alone. Transesophageal echocardiography is a useful noninvasive method to further define or confirm the diagnosis. Early surgical intervention is necessary in patients with this condition to prevent profound shock and end-organ failure.

HeartMate left ventricular assist device for long-term circulatory support.

We describe three successful cases of HeartMate left ventricular assist device (LVAD; Thermo Cardiosystems, Woburn, MA, USA) implantation in patients with end-stage heart failure for long-term circulatory support. Patient 1 was a 34-year-old woman with postpartum cardiomyopathy. Patients 2 and 3 were both males with dilated cardiomyopathy, 50 years and 21 years of age, respectively. They all presented in cardiogenic shock with decreased sensorium and anuria. Temporary mechanical support with an intra-aortic balloon pump or extracorporeal membrane oxygenation (ECMO) was needed for life support. Because bleeding and right ventricular failure often occur after HeartMate LVAD implantation, we used a Vascutek tube (Vascutek Ltd, Inchinnan, Scotland) graft to wrap inflow and outflow valve conduits and ECMO as a bridge to HeartMate LVAD implantation. Following surgery, cardiac output increased from 2.70, 2.06 and 2.53 L/min to 4.50, 5.80 and 5.00 L/min in the three patients. HeartMate LVAD can provide safe and stable long-term circulatory support without the need for anticoagulation. One of the patients remained on HeartMate for 287 days before undergoing successful heart transplantation. Patients with HeartMate LVAD are ambulatory and may be discharged while awaiting heart transplantation. Heart function may recover after long-term ventricular unloading with HeartMate LVAD.

Partial left ventriculectomy as a biologic bridge to heart transplantation.

Heart failure refractory to medical treatment is consuming an increasingly large proportion of health care resources. Partial left ventriculectomy has recently been used to treat patients with end-stage dilated cardiomyopathy. A 45-year-old man in end-stage heart failure had progressive exertional dyspnea for 3 years. Cardiac catheterization showed dilated cardiomyopathy with severe pulmonary hypertension and severely impaired left ventricular function. After partial left ventriculectomy, cardiac output increased from 2.11 L/min to 5.0 L/min. The left ventricular ejection fraction measured by radionuclide angiography increased from 13% preoperatively to 28% 1 month after the operation. The patient was discharged and monitored at the outpatient clinic. He had an exercise capacity of NYHA functional class II. However, he received heart transplantation 10 months after the partial left ventriculectomy because of recurrent heart failure. Partial left ventriculectomy improves heart function and may be used as a bridge to heart transplantation as an alternative to ventricular assist devices.